A medical expert has claimed two women did not need to have their wombs removed by a surgeon who is facing allegations of poor professional performance.

Rotunda Hospital clinical director Peter McKenna said it was also his view that the "pattern" of patients of Peter Van Geene suffering post-operative bleeding was "serious and significant" and that carrying out the procedures "didn't make sense".

He said he was also concerned by the surgeon's inability to be "introspective" and added that to "spread the blame" to his patients for surgical complications was "inexplicable".

The tribunal heard evidence from Dr McKenna, the former master of the Rotunda Hospital, on the fifth day of the fitness to practise inquiry.

The allegations are by four patients of Mr Van Geene who underwent hysterectomies at the Aut Even private hospital between 2009 and 2011.

"Looking at the pattern of outcomes and alleged exchanges with patients, I would have concern about the poor professional performance of the individual," Dr McKenna told the inquiry, addressing the allegations of all four women.

In relation to Patient A, the inquiry heard she had presented with post-menopausal bleeding and had complained of suffering from stress. Mr Van Geene agreed to perform the hysterectomy in April 2009. Dr McKenna said he "did not see what could be achieved" by performing the procedure.

"That's like saying if you have indigestion because of stress, remove your stomach," he said. "It's nonsense.

"I cannot understand the rationale in treating this patient at all. To me, it doesn't make a whole lot of sense," he added. "To me, I feel the patient had the wrong operation."

In the case of another patient, Helen Cruise, who waived her anonymity, he said he could not understand why a hysterectomy was carried out when the issue was incontinence.

"I do not see how a vaginal hysterectomy can fix a urinary problem," he said. "It was no wonder Ms Cruise isn't feeling any better."

Ms Cruise also alleged Mr Van Geene had shouted at her at a meeting after her operation and said her post-operative bleeding was because she had coughed and caused ligatures to come out.

"If you have caused a complication, you don't have a leg to stand on," Dr McKenna said, adding he would expect someone working under him to inform the patient of the problem, apologise, and accept responsibility.

In relation to the allegation that he had thrown Ms Cruise's womb into a bucket, he said he understood "how something like that could be said and it could be misinterpreted".

In relation to Patient C, who needed six units of blood, he said no one in his hospital could recall a patient getting that much blood in 10 years. He also said some of the allegations, if "stand alone" problems, would not, in his view, amount to poor professional performance.

Mr Van Geene is expected to dispute the allegations when he gives evidence.